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General NPI Number Information
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NPI Number | 1194495978
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Entity Type | Individual
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Provider Name | MITCHELL JOSEPH MASON
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Gender | Male
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 117 HOSPITAL DR
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City | PETERSBURG
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State | WV
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Zip | 26847-9566
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Country | US
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Telephone | 304-257-1026
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Fax |
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Provider Business Mailing Address
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Address Line | 35 PINOAK LN
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City | PARSONS
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State | WV
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Zip | 26287-8045
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Country | US
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Telephone | 304-704-9085
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004446
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License Number State | WV
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